Injectables (Fillers, Botox, More)

Darren M. Smith, MD

Board Certified Plastic Surgeon located in Upper East Side, New York, NY

Dr. Darren Smith is a board certified plastic surgeon on New York City’s upper east side. He is known for his excellent results with many different types of injectables, such as Botox, fillers, Kybella, and more. His unique fellowship training in aesthetic surgery and craniofacial surgery set him apart as one of NYC’s premier cosmetic injectors. Book your consultation using our book online tool to schedule online or call the office to schedule over the phone.

Injectables (Fillers, Botox, and more)

Cosmetic injectables offer a noninvasive, no-downtime way to look great. A wide range of injectables is available to enhance, refresh and rejuvenate. Injectables (with one exception, which we will get to below) can be broken down into two major categories: neuromodulators (like Botox, Dysport and Xeomin) and fillers (like Juvederm, Restylane, and many others). To better understand the role of fillers and neuromodulators in facial rejuvenation, it is helpful to discuss the two different kinds of lines on the face and what causes each type.

“Dynamic” lines are lines that appear when the muscles of the face contract to create facial expressions (for example the horizontal lines on the brow that occur when the eyebrows are raised). These appear because when muscles contract, the skin over them folds in order to move (like when you open a book and the spine wrinkles). With repeated brow motion over time, these dynamic lines actually cause the other kind of lines on the face: “static” lines.

“Static lines” are the lines present on your face when your face is at rest. Going back to the book analogy, a new book will have a smooth spine. When it is opened for the first few times, lines appear on the spine only while it is open (the dynamic lines). Over time, however, the dynamic lines on the spine of the book will cause permanent lines that are present on the spine of the book even when it is closed (the static lines).

Neuromodulators, like Botox, are useful in treating dynamic lines. They work by weakening the muscles in the area in a carefully controlled manner to minimize overlying wrinkle formation. Neuromodulators can be used for the prevention of static lines before they start. Once static lines are present, however, it is very hard if not impossible to treat them with neuromodulators.

Fillers, like Restylane, are used to treat static lines and to add volume to the face. The fillers used in our practice are for the most part gels that are different formulations of hyaluronic acid, a substance naturally present in the body that can be placed in creases to dramatically lessen their severity. They can also be added to provide volume in regions of the face that have “sunken” or “deflated” over time. Hyaluronic acid-based fillers can also be dissolved if necessary for any reason, so these filler procedures are reversible.

Recall that we mentioned earlier that there is one cosmetic injectable that does not fall into the two major categories of injectables: Kybella. This product is used to dissolve well-defined pockets of excess fat. It is specifically designed to treat “double chins.”

There is great deal of art and science that goes into designing an individualized injectable treatment plan. Dr. Smith will work with you one-on-one to design your optimal approach to cosmetic injectables. We hope the basic principles we have shared here were helpful and offer background to bring with you to your consultation.